All treatment methods under study were appropriate for achieving comparable clinical and functional outcome. The internal fixator is superior in restoration of the spinal alignment. Best radiological outcome is achieved by combined stabilization. Merely by direct reconstruction of the anterior column the postoperative re-kyphosing is prevented and a gain in segmental angle is achieved.

Even immediate anatomical reduction and sufficient stabilization cannot always decrease the rate of talar necrosis and peritalar arthrosis.

A follow-up after 2 years on average could be done in 43 cases of pelvic ring injuries. Seven were type A, 8 type B and 28 type C lesions. Every type A lesion was treated non-operatively. External fixation and non-operative management were used with type B injuries. As well as non-operative treatment, both internal and external surgical techniques were employed for type C fractures. While group A hardly mentioned pain in the follow-up, groups B and C suffered dorsal pelvic pain of comparable intensity irrespective of the therapeutic measures taken. Anatomic reduction does not guarantee freedom from pain. We also rated hip joint flexibility and ability to walk according to the Merle D'Aubigné score. Because of their pelvic injuries 50% of the type C patients changed their profession. The sequelae of the accident on sports and leisure time activities will be considered as well as the subjective contentment evaluated. Unstable and dislocated pelvic ring injuries permanently interfere to a high degree with the quality of life. It is remarkable that many of the traumatic lesions which interfere with the quality of life are caused by the traumatic violence itself and cannot be influenced by the manner of surgical stabilization.

Standard X-ray views in combination with standardized aiming of screw entry position and final screw thread position enable the surgeon to find the "safe zone" for iliosacral screw insertion and to prevent iliosacral screw malpositioning with high accuracy.

To elucidate the safety of fibrin glue application, antibody formation against fibrinogen and thrombin was studied in rabbits. The pathophysiology of developed antibodies was tested by an intravenous challenge with both components and by related blood pressure measurements. All fibrin glue-treated animals developed antibodies against both components. The quantity of antibodies against thrombin (20.4 mg/mL) was higher than the quantity against fibrinogen (0.38 mg/mL). The intravenous challenge with both components resulted in a significant and long-lasting blood pressure decrease to about 50% of the control values, indicating that these antibodies can induce circulatory disorders by antigen-antibody reaction, activation of the complement cascade, and liberation of histamine. Since rabbits promptly produce antibodies against antigenic material and humans do not, the results of this investigation suggest that fibrin glue should be used with caution in humans.